A Billing Code for Empathy

“You have a nice bedside manner. I don’t feel stupid being honest about the health concerns I have. And I don’t feel like you’re judging me when I tell you my A1C went up; that makes it easier to be honest with you about where I struggle.”

“I really appreciate that,” she said.

I’m in the process of switching to a new primary care clinician. I had found a clinician a year or two ago and the fit was convenient geographically, but the personality fit was not good. The previous doctor seemed preoccupied with checking boxes and following rigid protocols, seeing my health concerns in their own compartments instead of as part of a bigger whole. I really wanted to find a clinician who would let me tell her I had a routine dilated eye exam without launching into a big tirade about why I needed to have a dilated eye exam. (My old doctor did this all the time. “Do you smoke?” “No.” “Smoking is really bad for you.” … long pause ... “I agree. That’s why I don’t smoke.”)

My goal was to find someone who made eye contact, who was knowledgable, and who was willing to share mutual respect.

The clinician on call that day had a warm demeanor. She was thorough in gathering my medical history and didn’t immediately default to blaming my diabetes for everything that ailed me. Even though my appointment that day was about cutting myself with a saw, our interactions gave me hope that she might be the primary care clinician I was looking for.

So today, during my yearly physical, I asked if I could switch my care over to her in full. I told her what I was looking for in terms of a clinician/patient relationship and asked what she expected from me, as a patient. We all but shook on it. (Actually, we might have shaken on it.)

And now we’re partners in my healthcare. She’s willing to take me on as a patient, knowing I have a basket full of chronic conditions to juggle in addition to my tendency to be very upfront about my expectations. She came back at me with her own expectations and a kind appreciation for my engaged approach to healthcare. It’s only Visit 2 but it feels like a good fit. Our goals align.

“But there shouldn’t have to be,” she said. “It’s why I got into medicine. To help people. To help.”

I will do everything I can to make this patient/clinician relationship a good one, because I think this doc is a rare bird. Hopefully, in time, her application of careful and kind care will become less rare and more the norm. I know my health will benefit as a result of her care.

10 Comments

I’ve seen lots of excellent endos, but I’ve struggled to find a good fit for primary care. Partially because I have moved several times in the last decade, but also because it takes me a while to find a solid fit.

All the best for 2018 Kerri! I’ve followed your blog for a few years now, having an 11 year old daughter with Type 1. We lived in the US and moved to Australia (Melbourne) 6 years ago. We are very fortunate to have the Royal Children’s Hospital in Melbourne, one of the top hospitals on the planet and excellent Type 1 endos, clinicians and specialists. We have check ups quarterly. Relationships with health specialists are vital and I hope yours is a long and fruitful one. Please know that people across the world are inspired by your words and help us feel connected as a Type 1 community. You go girl for 2018!

Thanks Kerri. You clearly defined exactly what I’m looking for in a physician/patient relationship. Four years ago, because of an insurance change, I had to switch physicians and staff. It was very difficult. I now have a good endo, but I’ve found that my primary is lacking basic knowledge about life with T1. I like her as a person, but I need a different doctor.

I have an entire crew of specialists for my T1D care. My last PCP retired this past year and I’ve not searched out a new one (yet). I really seldom visit with a PCP as I have already scheduled up to 18-months of appointments with my Endo, Retina Surgeon, Ophthalmologist, Heart Doctor, etc., etc.. All those are just “well-health, maintenance” visits … so why should I really “have” to go see a PCP?

[…] ask what I can do to help make our visits more productive, as the patient. I know my doctors are working within the confines of a healthcare system that makes him check boxes instead of making eye …, and I want them to know I remember that they are human, […]

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NONE of the information on this site is medical advice. None. If you are thinking about making changes in your diabetes care, talk with your doctor. Don’t take advice from people on the Internet as “medical advice.” I am not a doctor. I can’t even drive stick.